Postoperative wound dressing

ABSTRACT

A unitary medical dressing is provided which includes a generally elastic bandage wrap configured for rapid attachment to a wearer, a generally inelastic absorbent pad affixed to the bandage wrap, a medicated, non-adherent gauze mesh affixed to the absorbent pad opposite the bandage wrap, and an adhesive affixed to the perimeter of the gauze mesh so as to adhere to the wearer&#39;s skin.

TECHNICAL FIELD

The present invention relates generally to medical dressings, and moreparticularly, to a ready-to-use postoperative wound dressing whichadjusts to movements of the body while still protecting the wound. Theinvention is especially well-suited for use as a knee, elbow and/or hipdressing, and thus is described in that context below.

BACKGROUND ART

At present, the medical arts include a broad array of dressings,bandages and wound coverings, many of which consist of nothing more thana strip of fabric secured to a patient by some sort of fastening device.These dressings often are wrapped around the patient's body, thetightness of the wrap being relied upon to hold the dressing in place.Unfortunately, most conventional dressings tend to rotate or slideacross the wound due to prying fingers or movement of the patient'sbody. This in turn may result in removal of any salves, ointments and/ormedicaments from the dressing, leading to patient discomfort, and quitepossibly to infection of the patient's wound. These undesirable effectsmay be exacerbated where the wound is uncovered, or where the dressingbecomes loose, as is common where conventional dressings are used tocover a joint such as a knee, elbow or hip.

To address these problems, some physicians have proposed the use ofadhesive tape to secure dressings in place over wounds, the tapegenerally being adhered directly to the patient's skin. Such anarrangement, however, is not entirely satisfactory. Adhesive tape, forexample, may loosen due to body movement or patient perspiration, andmay cause injury due to forces exerted on the patient's skin. Also,although adhesive tapes generally are capable of a degree of conformanceto a body surface when first applied, they do not accommodate movementof the body surface itself. If applied over a joint, movement of thebody may cause the tape to pull away from the skin, may damage thesurrounding tissue, or may even restrict movement of the joint.Conventional use of adhesive tape, thus may lead to an increasedpotential for patient injury and/or infection of the wound.

Known dressings also have experienced problems due to wicking, an effectwhereby bacteria or other contaminants may be drawn into a dressed woundalong a fluid path. This problem has proven especially troublesome inpostoperative dressings, particularly those which are asked to absorbsubstantial amounts of blood or other fluid from a wound. Ifunaddressed, such fluids can define a channel along which bacteria andother contaminants can pass to the wound. Again, infection or injury mayresult. Where the dressing is compressive, the potential for injuryfurther may be increased due to the pressure which the dressing placeson the anatomy surrounding the wound (e.g., blood vessels and nerves inthe popliteal space). Such dressings also have been known to adhere to awound or surrounding skin, raising the potential for shear injury to theskin when the dressing is removed. Additionally, known compressivedressings have been criticized as difficult to apply, particularly wherethe dressing is constructed at the time of application so as to producea dressing for a patient-specific, or wound-specific use.

It is an object of the present invention to provide a dressing which maybe readily secured to a wound and held in place during movements of thepatient's body.

The invention also is intended to provide a compressive, protectivebarrier to infection and prying fingers without unduly restrictingpatient movement.

Another object of the invention is to provide a dressing with anabsorbent pad configured to draw fluid away from a wound withoutproviding increased access to bacteria or other contaminants.

It is yet another object of the invention to provide a medicateddressing which will not unduly adhere to the patient's wound or skin.

DISCLOSURE OF THE INVENTION

The present invention addresses the above-identified problems andconcerns by provision of a unitary medical dressing which includes agenerally elastic bandage wrap, a generally inelastic absorbent padaffixed to the bandage wrap, a medicated, non-adherent gauze meshaffixed to the absorbent pad opposite the bandage wrap, and an adhesivearranged at least partially about the perimeter of the gauze mesh so asto adhere to the wearer's skin.

The bandage wrap is defined with a wound-covering section from whichextends a plurality of elongate strap sections, each strap section beingconfigured to secure the dressing to the wearer by wrapping around apredetermined body part. The strap sections preferably are elastic,providing a somewhat compressive bandage wrap. As illustrated in thedrawings, the dressing may be configured for use in covering a woundwhich is near a joint such as a knee, the strap sections beingpositioned to wrap around the patient's thigh and calf. Similarly, thedressing may be configured to cover a wound on the patient's hip, thestrap sections correspondingly wrapping around the patient's waist andthigh. Each strap section is provided with a hook-and-loop fastener,allowing for quick application and removal of the dressing.

The absorbent pad is affixed to the interior of the wound-coveringsection of the bandage wrap, and the gauze mesh is affixed to theinterior of the absorbent pad. The adhesive is arranged along at leastportions of the gauze mesh perimeter, adhering to the patient's skin,and thereby fixing the position of the gauze mesh over the wound. Thecompressive effect of the bandage wrap, further secures the dressing tothe patient so as to diminish the load on the adhesive. The absorbentpad draws fluid from the wound through the gauze mesh, but passage ofbacteria or other contaminants to the wound is inhibited due to abactericide or other medicament which is applied to the mesh. Further,the gauze mesh may be impregnated with a non-adherent compound such aspetrolatum in order to avoid adhesion of the gauze to the wound.

These and other objects and advantages of the present invention will bemore readily understood after a consideration of the drawings and thedetailed description of the preferred embodiment which follows.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an interior plan view of a medical dressing constructed inaccordance with a preferred embodiment of the present invention.

FIG. 2 is sectional side view of the depicted medical dressing takengenerally along line 2--2 of FIG. 1.

FIG. 3 is an exterior plan view of the medical dressing depicted in FIG.1.

FIG. 4 is a side view of the medical dressing depicted in FIG. 1, thedressing having been applied so as to cover a wound on a patient's knee.

FIG. 5 is an isometric view of an alternative embodiment medicaldressing, the dressing having been applied so as to cover a wound on apatient's hip.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT AND BEST MODE FORCARRYING OUT THE INVENTION

Referring now to the drawings, and in particular FIGS. 1 through 4,there is shown a postoperative wound dressing 10 which includes asheet-like bandage wrap 12 in the form of a resilient fabric strip. Thebandage wrap preferably is formed of an elastic material which has some"stretch" or "give" along both its length and width so as to enhance thepatient's comfort when the dressing is worn. The bandage wrap may, forexample, be formed of neoprene, or of a similar elastic material such asthat used in a conventional ACE™ bandage wrap.

As indicated, bandage wrap 12 includes a wound-covering section 14, anda plurality of elongate strap sections 16a, 16b, 18a, 18b. Thewound-covering section overlies the patient's wound. The strap sectionswrap around the patient's body to secure the dressing in place. Theparticular configuration of the strap sections and wound-coveringsection is dependant on the dressing's intended use.

In the embodiment depicted in FIGS. 1 through 4, dressing 10 isconfigured for use in dressing a knee wound. Bandage wrap 12 thus willbe seen to include a wound-covering section which is intermediate thestrap sections, each strap section extending outwardly from thewound-covering section to wrap the dressing around a portion of thepatient's leg 11 (FIG. 4). The strap sections are arranged insubstantially parallel fashion, and are paired so as to cooperativelywrap around the patient's leg. Strap sections 16a, 16b, for example,extend oppositely from the wound-covering section to wrap around thepatient's calf 11a. Strap sections 18a, 18b are spaced from strapsections 16a, 16b and extend oppositely from the wound-covering sectionto wrap around the patient's thigh 11b. The wound-covering sectioncovers the patient's knee. The popliteal portion of the leg is thus leftuncovered, allowing for mobility of the patient's leg.

Each strap section is provided with a fastener 20, 22, such fastenersbeing configured to secure the straps together, and thus to hold thebandage wrap on the patient's leg. The fasteners preferably take theform hook-and-loop fasteners, providing for rapid attachment and removalof the bandage wrap. Strap sections 16a, 18a are each provided with astrip of loop fastener material on the exterior surface of the bandagewrap. Strap sections 16b, 18b are each provided with a strip of hookfastener material on the interior surface of the bandage wrap. Strapsections 16b, 18b thus may be wrapped around the patient's leg until thehook fastener strips overlap the loop fastener strips such that thestrap sections may be secured in place. The fasteners are madeadjustable, the hook and loop fastener strips having lengths which allowfor varying degrees of overlap. By securing hook fastener strips 22 todifferent portions of loop fastener strips 20, it is possible to adjustthe tightness of the wrap, and thus to control the compression on thewound.

Those skilled will appreciate that the fasteners alternatively may takethe form of an adhesive or other chemical or mechanical fasteningdevice, and may be adapted for either single or repeated use. Similarly,the bandage wrap may employ more or fewer strap sections than shown, andmay strap sections which are configured to extend entirely around thewearer to fasten to the wound-covering section rather than to anotherstrap section.

The dressing also includes an absorbent pad 24 which is affixed to theinterior surface of the wound-covering section of bandage wrap 12. Pad24 is affixed centrally to the wound-covering section, preferably via areliable securement device such as stitching 24a. Instead of stitching,however, the absorbent pad may be attached to the bandage wrap by apermanent adhesive, or by a temporary adhesive which permits removal ofa used pad and substitution of a new pad. Furthermore, the absorptivepad need not be secured to the bandage wrap entirely about itscircumference, but rather may be secured on only two sides, or in thefour corners as shown in FIGS. 1 and 3.

The absorbent pad may be woven, knitted, or otherwise constructed toprovide for the absorption of fluid (e.g., blood or serous fluid) whichdrains from the patient's wound. In the preferred embodiment, the pad iswoven from hydrophilic fibers such as hydrophilic cotton or fibrane, butother hydrophilic materials (including nonwoven hydrophilic materialssuch as bonded fibrous materials) could be used without departing fromthe invention as defined herein. The thickness of the pad is notcritical to the invention, it being dependent upon the absorptioncharacteristics of the material used. A typical useful thickness of anabsorptive cotton pad, however, would be approximately 0.5-inches to1.5-inches thick.

In accordance with one feature of the invented dressing, it will beappreciated that the absorptive pad may be formed of a generallyinelastic material such as cotton or linen so as to limit stretch of thedressing in the area of the wound. This in turn will reduce thepotential for injury which might otherwise result from external forceson the dressing. Also, because the bandage wrap is generally elastic,the strap sections will maintain the elastic nature of the dressing as awhole.

A gauze mesh 26 is affixed centrally to absorbent pad 24, such gauzemesh being secured centrally to the interior of the absorbent pad,preferably by some sort of stitching or adhesive as was previouslydescribed in connection with the absorbent pad. In the preferredembodiment, the gauze mesh is adapted to treat the patient's wound,being impregnated with a bactericide (e.g., providone-iodine orchloramine-T) or other medicament which avoids infection of the wound.The gauze mesh also is impregnated with a lubricant such as petrolatum,making for non-adherent contact between the dressing and the wound. Boththe bactericide and the lubricant, it will be appreciated, are appliedto the wound do to micro-movement of the gauze mesh.

In order to provide for proper wound drainage, the gauze mesh is of adensity which will allow passage of fluids from the wound to theabsorbent pad. Passage of bacteria to the wound, however, will beinhibited by the bactericide on the gauze mesh. The gauze meshpreferably is chosen so as to define a 25-mesh screen, allowing pad 24to draw fluids through the openings in the gauze mesh. The gauze meshthus generally will be less dense than a fine or regular gauze mesh. Thegauze mesh may, however, be chosen in accordance with the particulardrainage requirements of the to-be-treated wound.

As best indicated in FIG. 1, an adhesive such as tape 28 is applied tothe gauze mesh along at least a portion of its perimeter, the tape beingconfigured with an adhesive surface facing the patient's skin so as tofix the gauze mesh in place over the patient's wound. In the preferredembodiment, the adhesive tape is a double-sided foam tape which adhereson one side to the gauze mesh, and adheres on the other side to thepatient's skin. The tape thus serves both to center the gauze mesh overthe wound, and to improve protection of the wound by defining at least apartial barrier to contaminants, irritants or intrusive fingers whichmight otherwise disturb the wound.

It will be noted, however, that the tape need not extend entirely aroundthe gauze mesh perimeter, the depicted dressing including noticeablegaps in the tape. These gaps are chosen to minimize stress on thepatient's skin and to allow crenelation of the generally inelasticabsorbent pad. In the-current embodiment, for example, these gapscorrespond to that portion of the knee where the skin expands andcontracts most upon bending of the knee.

The adhesive tape should be formed of an inert material and should benon-irritating to the skin. For comfort, the tape should be lightweight, and should be sufficiently elastic so as not to restrict eithercirculation or surface dimension changes in that part of the skin whichis covered by the tape. Synthetic sponge materials of the type includinga foamed mass of plastic are eminently suitable for such use. They areresiliently yieldable, and readily conformable to the body surface,while at the same time possessing great tensile strength.

In order to preserve the sterile nature of the dressing, the adhesivetape further may be used to hold a sterile covering over the gauze meshprior to use of the dressing. The covering is removed at the time of useto expose the gauze mesh, and the dressing is applied such that thegauze mesh covers the wound in the manner described above.

The dressing thus defines a non-adherent, bacteriocidal barrier withabsorption characteristics which provide adequate drainage from a wound.The gauze mesh is held in place over the wound by a resilient adhesivetape, the tape generally being configured to provide a protectivebarrier about at least a portion of the wound without unduly limitingthe patient's ability to flex. The bandage wrap provides compression tothe wound, but works together with the adhesive tape to hold thedressing in place.

FIG. 5 shows a wound dressing 10' formed in accordance with analternative embodiment of the present invention so as to provide for useof the dressing to cover a wound on a patient's hip 11'. Dressing 10' issimilar to dressing 10, the principle difference being in the characterof the bandage wrap 12'. As indicated, bandage wrap 12' is configured toplace its wound-covering section 14' over the patient's hip when thedressing is applied. Bandage wrap 14' thus is specially provided withstrap sections 16a', 16b', 18a', 18b' which wrap around the patient'swaist and thigh. Strap sections 16a', 16b' cooperate to wrap around thepatient's thigh 11a'. Strap sections 18a', 18b' cooperate to wrap aroundthe patient's waist 11b'.

While the present invention has been shown and described with referenceto the foregoing operational principles and preferred embodiment, itwill be apparent that to those skilled in the art that various changesin form and detail may be made without departing from the spirit andscope of the invention as defined by the appended claims.

I claim:
 1. A unitary medical dressing comprising:a bandage wrap including a wound-covering section from which extends at least one elongate strap section, said strap section being configured to secure the bandage wrap to a wearer; an absorbent pad affixed to said wound-coveting section for placement over a wound upon securing said bandage wrap to the wearer; a gauze mesh affixed to said absorbent pad opposite said bandage wrap so as to cover the wound upon securing said bandage wrap to the wearer; and an adhesive arranged substantially about a perimeter of said gauze mesh and overlying said gauze mesh to frame said gauze mesh, said adhesive being a sole source of adhesion to the wearer and thereby, fixing said gauze mesh to a wearer in place over the wound upon securing said bandage wrap to the wearer.
 2. The dressing of claim 1, wherein said bandage wrap is formed of a generally elastic material.
 3. The dressing of claim 2, wherein said absorbent pad is formed of a generally inelastic material.
 4. The dressing of claim 1, wherein said gauze mesh is medicated.
 5. The dressing of claim 1, wherein said gauze mesh is impregnated with a bactericide.
 6. The dressing of claim 5, wherein said gauze mesh is further impregnated with a petrolatum blend.
 7. The dressing of claim 1, wherein said gauze mesh is of a density which allows passage of fluids from the wound to said absorbent pad.
 8. The dressing of claim 1, wherein said gauze mesh is approximately a 25-mesh screen.
 9. The dressing of claim 1, wherein said adhesive is an adhesive tape secured to said gauze mesh perimeter.
 10. The dressing of claim 1, wherein said adhesive is a foam tape.
 11. The dressing of claim 1, wherein said adhesive is a double-sided tape which adheres on one side to said gauze mesh, and on another side to the wearer's skin.
 12. A unitary medical dressing comprising:a generally elastic non-adherent bandage wrap including a wound-covering section from which extends a plurality of elongate strap sections, each strap section being configured to secure the bandage wrap to a wearer by wrapping about a predetermined portion of the wearer's body; a generally inelastic absorbent pad affixed to said wound-covering section for placement over a wound upon securing said bandage wrap to the wearer; a medicated, non-adherent gauze mesh affixed to said absorbent pad opposite said bandage wrap so as to cover the wound, said gauze mesh being configured to allow passage therethrough of fluids from the wound to said absorbent pad; and an adhesive tape secured to said gauze mesh substantially about a perimeter of said gauze mesh and overlying said gauze mesh to frame said gauze mesh, said adhesive tape being a sole source of adhesion to the wearer and including an adhesive surface which faces opposite said gauze mesh to adhere to the wearer's skin in an area surrounding, but not overlying the wound to fix said gauze mesh in place over the wound.
 13. The dressing of claim 12, wherein said strap sections extend from said wound-covering section in parallel fashion.
 14. The dressing of claim 12, wherein said bandage wrap includes at least two spaced-apart strap sections which extend in parallel fashion from said wound-covering section to provide a first strap section configured to wrap around a predetermined first portion of the wearer's body, and a second strap section configured to wrap around a predetermined second portion of a wearer's body.
 15. The dressing of claim 14, wherein said first strap section is configured to wrap around the wearer's calf and said second strap section is configured to wrap around the wearer's thigh.
 16. The dressing of claim 14, wherein said first strap section is configured to wrap around the wearer's thigh and said second strap section is configured to wrap around the wearer's waist.
 17. The dressing of claim 12, wherein each strap section includes an adjustable fastener, each fastener being adjustable to vary tightness of said bandage wrap.
 18. The dressing of claim 17, wherein said fastener are a hook-and-loop fasteners.
 19. The dressing of claim 12, wherein each strap section is paired with another strap section, each strap section pair being configured to wrap oppositely around the wearer's body and fasten to one another to hold said bandage wrap in place.
 20. A unitary medical dressing configured for removable securement to a wearer to cover and protect a wound, said dressing comprising:a bandage wrap including a wound-covering section, and a plurality of elongate, generally elastic strap sections which extend in parallel fashion from said wound-covering section to wrap about predetermined portions of the wearer's body, each strap section being paired with another strap section and configured to wrap oppositely around the wearer's body an fasten to another strap via an adjustable fastener to provide for adjustment of compression on the wound; a generally inelastic absorbent pad affixed to said wound-coveting section for placement over the wound upon applying said bandage wrap to the wearer; a medicated, non-adherent gauze mesh affixed to said absorbent pad opposite said bandage wrap so as to cover the wound, said gauze mesh being configured to allow passage therethrough of fluids from the wound to said absorbent pad, but to inhibit passage of bacteria toward the wound; and a pair of facing, generally C-shaped adhesive tape strips secured to said gauze mesh substantially about a perimeter of said gauze mesh and overlying said absorbent pad, said adhesion tape strips being a sole source of adhesion to the wearer, said adhesive tape strips each including an adhesive surface which faces opposite said gauze mesh to adhere to the wearer's skin in an area surrounding, but not overlying, the wound, thus fixing said gauze mesh both laterally and translationally in place over the wound while allowing crenelation of the generally inelastic absorbent pad. 